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与临床判断相比,决策支持工具是否降低了医院获得的静脉血栓栓塞的患病率? 一个单一的中心前后研究.

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在医院获得的静脉血栓塞栓症 (HA-VTE) 预防中实施强制性决策支持工具 (DST) 并没有显著改变HA-VTE发病率或患者逗留时间. 医疗保健专业人员报告说,他们对DST的不满和工作流程中断.

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决策支持工具 决策支持工具在医院获得的静脉血栓栓塞瘤.风险评估模型风险评估模型

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科学领域:

  • 医疗信息学 医疗信息学
  • 患者安全 患者安全
  • 医疗保健服务研究 医疗服务研究

背景情况:

  • 在医院获得的静脉血栓塞栓瘤 (HA-VTE) 给患者带来了巨大的患者和经济负担.
  • 目前的VTE预防依赖于通过订单集感知到的风险,但建议使用标准化的风险评估模型.
  • 整合风险模型的决策支持工具 (DST) 可以改善预防,但可能会导致医疗保健专业人员的疲劳.

研究的目的:

  • 为了评估强制性DST对HA-VTE发病率和停留时间的影响.
  • 评估医疗保健专业人员对实施的DST的满意度.

主要方法:

  • 在第三级医疗中心进行了回顾性,实施前后的观察性研究.
  • 在医疗和手术患者的强制性DST中,分别利用了帕多瓦和卡普里尼的得分.
  • 通过ICD-10代码和电子图表收集数据;匿名调查医疗保健专业人员.

主要成果:

  • 在DST实施之前和之后每月每1000次出院的HA-VTE发病率没有统计学上显著的差异 (4.4与4.6).
  • 住院时间保持不变 (14.2天前 vs. 14.1天后).
  • 84%的受访专业人士报告高不满,其中91%表示它减缓了他们的工作流.

结论:

  • 与之前的基于风险的订单集相比,强制性DST实施并没有改变HA-VTE的流行率,停留时间或再接收率.
  • 需要进一步的研究来完善风险评估模型,并提高医疗保健专业人员的DST可用性和满意度.